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Who Should Try Gel Injections (and Who Shouldn’t) Ideal Candidates for Gel Injections After treating tens of thousands of patients, I’ve identified the characteristics that predict the best outcomes: KL Grade 2–3 (mild to moderate arthritis with cartilage still present) KL Grade 4 patients willing to commit to repeated courses every 6 months (see all bone-on-bone knee treatment options) Patients who have tried physical therapy and medication without adequate relief Those who want to delay surgery as long as possible Patients who value maintaining their current activity level Those with realistic expectations about gradual (not instant) improvement When I Recommend Surgery Instead I believe in honest conversations with my patients

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